Chapter 15 *APR Lecture PowerPoint The Autonomic Nervous System and Visceral Reflexes *See separate FlexArt PowerPoint slides for all figures and tables preinserted into PowerPoint without notes. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Introduction • Autonomic means “self-governed” and fully independent • It regulates fundamental states and life processes such as heart rate, BP, and body temperature • Walter Cannon coined the terms “homeostasis” and the “flight-or-fight” reaction, dedicated to his career in the study of ANS 15-2 General Properties of the Autonomic Nervous System • Expected Learning Outcomes – Explain how the autonomic and somatic nervous systems differ in form and function. – Explain how the two divisions of the autonomic nervous system differ in general function. 15-3 General Properties of the Autonomic Nervous System • Autonomic nervous system (ANS)—a motor nervous system that controls glands, cardiac muscle, and smooth muscle – Also called visceral motor system – Primary organs of the ANS • Viscera of thoracic and abdominal cavities • Some structures of the body wall – Cutaneous blood vessels – Sweat glands – Piloerector muscles 15-4 General Properties of the Autonomic Nervous System • Autonomic nervous system (ANS) (cont.) – Carries out actions involuntarily: without our conscious intent or awareness • Visceral effectors do not depend on the ANS to function; only to adjust their activity to the body’s changing needs • Denervation hypersensitivity—exaggerated response of cardiac and smooth muscle if autonomic nerves are severed 15-5 Visceral Reflexes • • Visceral reflexes—unconscious, automatic, stereotyped responses to stimulation involving visceral receptors and effectors and somewhat slower responses Visceral reflex arc – Receptors: nerve endings that detect stretch, tissue damage, blood chemicals, body temperature, and other internal stimuli – Afferent neurons: leading to the CNS – Interneurons: in the CNS – Efferent neurons: carry motor signals away from the CNS – Effectors: that make adjustments • ANS modifies effector activity 15-6 Visceral Reflexes Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. • High blood pressure detected by arterial stretch receptors (1), afferent neuron (2) carries signal to CNS, efferent (3) signals travel to the heart, then (4) heart slows reducing blood pressure • Example of homeostatic negative feedback loop 2 Glossopharyngeal nerve transmits signals to medulla oblongata 1 3 Vagus nerve transmits inhibitory signals to cardiac pacemaker Baroreceptors sense increased blood pressure Common carotid artery Terminal ganglion 4 Heart rate decreases Figure 15.1 15-7 Divisions of the ANS • Two divisions innervate same target organ – May have cooperative or contrasting effect – Prepares body for physical activity: exercise, trauma, arousal, competition, anger, or fear • Increases heart rate, BP, airflow, blood glucose levels, etc. • Reduces blood flow to the skin and digestive tract • Parasympathetic division – Calms many body functions reducing energy expenditure and assists in bodily maintenance • Digestion and waste elimination • “Resting and digesting” state 15-8 Divisions of the ANS • Autonomic tone—normal background rate of activity that represents the balance of the two systems according to the body’s changing needs – Parasympathetic tone • Maintains smooth muscle tone in intestines • Holds resting heart rate down to about 70 to 80 beats per minute – Sympathetic tone • Keeps most blood vessels partially constricted and maintains blood pressure • Sympathetic division excites the hearts but inhibits digestive and urinary function, while parasympathetic has the opposite effect 15-9 Autonomic Output Pathways • ANS has components in both the central and peripheral nervous systems – Control nucleus in the hypothalamus and other brainstem regions – Motor neurons in the spinal cord and peripheral ganglia – Nerve fibers that travel through the cranial and spinal nerves • Somatic motor pathway – A motor neuron from the brainstem or spinal cord issues a myelinated axon that reaches all the way to the skeletal muscle 15-10 Autonomic Output Pathways • Autonomic pathway – Signal must travel across two neurons to get to the target organ – Must cross a synapse where these two neurons meet in an autonomic ganglion – Presynaptic neuron: the first neuron has a soma in the brainstem or spinal cord – Synapses with a postganglionic neuron whose axon extends the rest of the way to the target cell 15-11 Autonomic Output Pathways Copyright © The McGraw-Hill Companies, Inc. 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Somatic efferent innervation ACh Myelinated fiber Somatic effectors (skeletal muscles) Autonomic efferent innervation ACh Myelinated preganglionic fiber ACh or NE Unmyelinated postganglionic fiber Autonomic ganglion Visceral effectors (cardiac muscle, smooth muscle, glands) Figure 15.2 ANS—two neurons from CNS to effectors • Presynaptic neuron cell body is in CNS • Postsynaptic neuron cell body is in peripheral ganglion 15-12 Anatomy of the Autonomic Nervous System • Expected Learning Outcomes – Identify the anatomical components and nerve pathways of the sympathetic and parasympathetic divisions. – Discuss the relationship of the adrenal glands to the sympathetic nervous system. – Describe the enteric nervous system of the digestive tract and explain its significance. 15-13 The Sympathetic Division • • • Also called the thoracolumbar division because it arises from the thoracic and lumbar regions of the spinal cord Relatively short preganglionic and long postganglionic fibers Preganglionic neurosomas in lateral horns and nearby regions of the gray matter of spinal cord – Fibers exit spinal cord by way of spinal nerves T1 to L2 – Lead to nearby sympathetic chain of ganglia (paravertebral ganglia) • Series of longitudinal ganglia adjacent to both sides of the vertebral column from cervical to coccygeal levels • Usually 3 cervical, 11 thoracic, 4 lumbar, 4 sacral, and 1 coccygeal ganglion • Sympathetic nerve fibers are distributed to every level of the body 15-14 Sympathetic Chain Ganglia Copyright © The McGraw-Hill Companies, Inc. 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Soma of preganglionic neuron To iris, salivary glands, lungs, heart, thoracic blood vessels, esophagus Sympathetic nerve 2 Somatic motor fiber Spinal nerve Preganglionic sympathetic fiber Postganglionic sympathetic fiber To somatic effector (skeletal muscle) 1 Soma of somatic motor neuron 3 White ramus Splanchnic nerve Gray ramus Preganglionic neuron Postganglionic neuron Somatic neuron Communicating rami Collateral ganglion Soma of postganglionic neuron Postganglionic sympathetic fibers Sympathetic trunk To liver, spleen, adrenal glands, stomach, intestines, kidneys, urinary bladder, reproductive organs Figure 15.5 To sweat glands, piloerector muscles, and blood vessels of skin and skeletal muscles Sympathetic ganglion 2 15-15 The Sympathetic Division • Each paravertebral ganglion is connected to a spinal nerve by two branches: communicating rami – Preganglionic fibers are small myelinated fibers that travel from spinal nerve to the ganglion by way of the white communicating ramus (myelinated) – Postganglionic fibers leave the ganglion by way of the gray communicating ramus (unmyelinated) • Forms a bridge back to the spinal nerve – Postganglionic fibers extend the rest of the way to the target organ 15-16 The Sympathetic Division • After entering the sympathetic chain, the postganglionic fibers may follow any of three courses – Some end in ganglia which they enter and synapse immediately with a postganglionic neuron – Some travel up or down the chain and synapse in ganglia at other levels • These fibers link the paravertebral ganglia into a chain • Only route by which ganglia at the cervical, sacral, and coccygeal levels receive input – Some pass through the chain without synapsing and continue as splanchnic nerves 15-17 The Sympathetic Division Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Eye Nasal glands Pons Salivary glands Preganglionic neurons Postganglionic neurons Carotid plexuses Heart Cardiac and pulmonary plexuses Regions of spinal cord Cervical Thoracic Lumbar Sacral Lung Celiac ganglion Liver and gallbladder Superior mesenteric ganglion Stomach Spleen Pancreas Postganglionic fibers to skin, blood vessels, adipose tissue Inferior mesenteric ganglion Small intestine Large intestine Rectum Sympathetic chain ganglia Adrenal medulla Kidney Figure 15.4 Ovary Penis Uterus Scrotum Bladder 15-18 Sympathetic Division The Sympathetic Chain Ganglia Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Cardiac n. Thoracic ganglion Communicating ramus Bronchi Superior vena cava Sympathetic chain Rib Splanchnic n. Heart Phrenic n. Vagus n. Diaphragm © From A Stereoscopic Atlas of Anatomy by David L. Basett. Courtesy of Dr. Robert A. Chase, MD. Figure 15.3 15-20 The Sympathetic Division • Nerve fibers leave the sympathetic chain by spinal, sympathetic, and splanchnic nerves – Spinal nerve route • Some postganglionic fibers exit a ganglion by way of the gray ramus • Return to the spinal nerve and travel the rest of the way to the target organ • Most sweat glands, piloerector muscles, and blood vessels of the skin and skeletal muscles 15-21 The Sympathetic Division • Routes (cont.) – Sympathetic nerve route • Other nerves leave by way of sympathetic nerves that extend to the heart, lungs, esophagus, and thoracic blood vessels • These nerves form carotid plexus around each carotid artery of the neck • Issue fibers from there to the effectors in the head – Sweat, salivary, nasal glands; piloerector muscles; blood vessels; dilators of iris • Some fibers of superior and middle cervical ganglia form cardiac nerves to the heart 15-22 The Sympathetic Division • Routes (cont.) – Splanchnic nerve route • Some fibers that arise from spinal nerves T5 to T12 pass through the sympathetic ganglia without synapsing – Continue on as the splanchnic nerves – Lead to second set of ganglia: collateral (prevertebral) ganglia and synapse there 15-23 The Sympathetic Division • Collateral ganglia contribute to a network called the abdominal aortic plexus – Wraps around abdominal aorta – Three major collateral ganglia in this plexus • Celiac, superior mesenteric, and inferior mesenteric • Postganglionic fibers accompany these arteries and their branches to their target organs – Solar plexus: collective name for the celiac and superior mesenteric ganglia • Nerves radiate from ganglia like rays of the sun 15-24 The Sympathetic Division Copyright © The McGraw-Hill Companies, Inc. 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Diaphragm Esophagus Adrenal medulla Adrenal cortex Celiac ganglia (b) Adrenal gland Celiac trunk Renal plexus Superior mesenteric ganglion First lumbar sympathetic ganglion Superior mesenteric artery Aortic plexus Inferior mesenteric artery Kidney Inferior mesenteric ganglion Aorta Pelvic sympathetic chain Figure 15.6 15-25 (a) The Sympathetic Division • Neuronal divergence predominates – Each preganglionic cell branches and synapses on 10 to 20 postganglionic cells – One preganglionic neuron can excite multiple postganglionic fibers leading to different target organs – Have relatively widespread effects 15-26 The Adrenal Glands • Paired adrenal (suprarenal) glands on superior poles of the kidneys • Each is two glands with different functions – Adrenal cortex (outer layer) • Secretes steroid hormones – Adrenal medulla (inner core) • Essentially a sympathetic ganglion • Consists of modified postganglionic neurons without dendrites or axons • Stimulated by preganglionic sympathetic neurons that terminate on these cells 15-27 Adrenal (Suprarenal) Glands Adrenal (Suprarenal) Glands Cortex & Medulla Capsule Cortex Medulla Suprarenal Gland Low Magnification Capsule of suprarenal gland Zona glomerulosa Suprarenal cortex Zona fasciculata Suprarenal medulla Medullary veins Zona reticularis The Adrenal Glands – Adrenal medulla (cont.) • Secretes a mixture of hormones into bloodstream • Catecholamines—85% epinephrine (adrenaline) and 15% norepinephrine (noradrenaline) • Also function as neurotransmitters • Sympathoadrenal system is the closely related functioning adrenal medulla and sympathetic nervous system 15-31 The Parasympathetic Division • Parasympathetic division is also called the craniosacral division – Arises from the brain and sacral regions of the spinal cord – Fibers travel in certain cranial and sacral nerves • Origin of long preganglionic neurons – Midbrain, pons, and medulla – Sacral spinal cord segments S2 to S4 15-32 The Parasympathetic Division • Pathways of long preganglionic fibers – Fibers in cranial nerves III, VII, IX, and X – Fibers arising from sacral spinal cord • Pelvic splanchnic nerves and inferior hypogastric plexus • Terminal ganglia in or near target organs – Long preganglionic, short postganglionic fibers • Neuronal divergence less than sympathetic division – One preganglionic fiber reaches the target organ and then stimulates fewer than five postganglionic cells 15-33 Parasympathetic Cranial Nerves Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Preganglionic neurons Pterygopalatine ganglion Oculomotor n. (CN III) Postganglionic neurons Ciliary ganglion Lacrimal gland • Oculomotor nerve (III) – Narrows pupil and focuses lens Eye Facial n. (CN VII) Submandibular ganglion Submandibular salivary gland Otic ganglion • Facial nerve (VII) Parotid salivary gland Glossopharyngeal n. (CN IX) – Tear, nasal, and salivary glands Vagus n. (CN X) Heart Cardiac plexus • Glossopharyngeal nerve (IX) Pulmonary plexus Regions of spinal cord Cervical Esophageal plexus – Parotid salivary gland Lung Thoracic Lumbar Sacral Celiac ganglion Stomach Liver and gallbladder Abdominal aortic plexus Spleen • Vagus nerve (X) Pancreas Pelvic splanchnic nerves Kidney and ureter Transverse colon Inferior Hypogastric plexus Descending colon Small intestine Rectum – Viscera as far as proximal half of colon – Cardiac, pulmonary, and esophageal plexus Pelvic nerves Penis Ovary Uterus Bladder Scrotum Figure 15.7 15-34 Parasympathetic Division The Parasympathetic Division Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Preganglionic neurons Pterygopalatine ganglion Oculomotor n. (CN III) Postganglionic neurons Ciliary ganglion Lacrimal gland Eye Facial n. (CN VII) Submandibular ganglion • Remaining parasympathetic fibers arise from levels S2 to S4 of the spinal cord Submandibular salivary gland Otic ganglion Parotid salivary gland Glossopharyngeal n. (CN IX) Vagus n. (CN X) Heart Cardiac plexus • Form pelvic splanchnic nerves that lead to the inferior hypogastric plexus Pulmonary plexus Regions of spinal cord Cervical Esophageal plexus Lung Thoracic Lumbar Sacral Celiac ganglion Stomach Liver and gallbladder Abdominal aortic plexus Spleen • Most form pelvic nerves to their terminal ganglion on the target organs – Distal half of colon, rectum, urinary bladder, and reproductive organs Pancreas Pelvic splanchnic nerves Kidney and ureter Transverse colon Inferior Hypogastric plexus Descending colon Small intestine Rectum Pelvic nerves Figure 15.7 Penis Ovary Uterus Bladder Scrotum 15-36 The Enteric Nervous System • Enteric nervous system—the nervous system of the digestive tract – Does not arise from the brainstem or spinal cord – Does innervate smooth muscle and glands • Composed of 100 million neurons found in the walls of the digestive tract • No components in CNS • Has its own reflex arcs • Regulates motility of esophagus, stomach, and intestines and secretion of digestive enzymes and acid • Normal digestive function also requires regulation by sympathetic and parasympathetic systems 15-37 Megacolon • Hirschsprung disease—hereditary defect causing absence of enteric nervous system – No innervation in sigmoid colon and rectum – Constricts permanently and will not allow passage of feces – Feces becomes impacted above constriction – Megacolon: massive dilation of bowel accompanied by abdominal distension and chronic constipation – May be colonic gangrene, perforation of bowel, and peritonitis – Usually evident in newborns who fail to have their first bowel movement 15-38 Autonomic Effects on Target Organs • Expected Learning Outcomes – Name the neurotransmitters employed at different synapses of the ANS. – Name the receptors for these neurotransmitters and explain how they relate to autonomic effects. – Explain how the ANS controls many target organs through dual innervation. – Explain how control is exerted in the absence of dual innervation. 15-39 Neurotransmitters and Their Receptors • How can different autonomic neurons have different effects— constricting some vessels but dilating others? – Effects determined by types of neurotransmitters released and types of receptors found on target cells • Two fundamental reasons – Sympathetic and parasympathetic fibers secrete different neurotransmitters – Target cells respond to the same neurotransmitter differently depending upon the type of receptor they have for it • All autonomic fibers secrete either acetylcholine or norepinephrine • There are two classes of receptors for each of these neurotransmitters 15-40 Neurotransmitters and Their Receptors • Acetylcholine (ACh) is secreted by all preganglionic neurons in both divisions and the postganglionic parasympathetic neurons – Called cholinergic fibers – Any receptor that binds it is called cholinergic receptor 15-41 Neurotransmitters and Their Receptors • Two types of cholinergic receptors – Muscarinic receptors • All cardiac muscle, smooth muscle, and gland cells have muscarinic receptors • Excitatory or inhibitory due to subclasses of muscarinic receptors – Nicotinic receptors • On all ANS postganglionic neurons, in the adrenal medulla, and at neuromuscular junctions of skeletal muscle • Excitatory when ACh binding occurs 15-42 Neurotransmitters and Their Receptors • NE is secreted by nearly all sympathetic postganglionic neurons – Called adrenergic fibers – Receptors for it called adrenergic receptors • Alpha-adrenergic receptors – Usually excitatory – Two subclasses use different second messengers (α1 and α 2) • Beta-adrenergic receptors – Usually inhibitory – Two subclasses with different effects, but both act through cAMP as a second messenger (β1 and β2) 15-43 Neurotransmitters and Their Receptors • Autonomic effects on glandular secretion are often an indirect result of their effect on blood vessels – Vasodilation: increased blood flow; increased secretion – Vasoconstriction: decreased blood flow; decreased secretion • Sympathetic effects tend to last longer than parasympathetic effects – ACh released by parasympathetics is broken down quickly at synapse – NE by sympathetics is reabsorbed by nerve, diffuses to adjacent tissues, and much passes into bloodstream 15-44 Neurotransmitters and Their Receptors • Many substances released as neurotransmitters that modulate ACh and NE function – Sympathetic fibers also secrete enkephalin, substance P, neuropeptide Y, somatostatin, neurotensin, or gonadotropin-releasing hormone – Parasympathetic fibers stimulate endothelial cells to release the gas, nitric oxide, which causes vasodilation by inhibiting smooth muscle tone • Function is crucial to penile erection—means of action of Viagra 15-45 Neurotransmitters and Their Receptors Copyright © The McGraw-Hill Companies, Inc. 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(a) Parasympathetic fiber Nicotinic receptor ACh Target cell ACh Preganglionic neuron Postganglionic neuron Muscarinic receptor (b) Sympathetic adrenergic fiber Nicotinic receptor ACh Target cell Preganglionic neuron Postganglionic neuron NE Adrenergic receptor (c) Sympathetic cholinergic fiber Nicotinic receptor ACh Target cell Preganglionic neuron Postganglionic neuron ACh Muscarinic receptor Figure 15.8 15-46 Dual Innervation • Dual innervation—most viscera receive nerve fibers from both parasympathetic and sympathetic divisions – Antagonistic effect: oppose each other – Cooperative effects: two divisions act on different effectors to produce a unified overall effect • Both divisions do not normally innervate an organ equally • Digestion, heart rate 15-47 Sympathetics & Parasympathetics Dual Innervation • Antagonistic effects—oppose each other – Exerted through dual innervation of same effector cells • Heart rate decreases (parasympathetic) • Heart rate increases (sympathetic) – Exerted because each division innervates different cells • Pupillary dilator muscle (sympathetic) dilates pupil • Constrictor pupillae (parasympathetic) constricts pupil 15-49 Dual Innervation • Cooperative effects—when two divisions act on different effectors to produce a unified effect – Parasympathetics increase salivary serous cell secretion – Sympathetics increase salivary mucous cell secretion 15-50 Dual Innervation of the Iris Copyright © The McGraw-Hill Companies, Inc. 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Brain Parasympathetic fibers of oculomotor nerve (III) Sympathetic fibers Superior cervical ganglion Ciliary ganglion Spinal cord Cholinergic stimulation of pupillary constrictor Iris Pupil Adrenergic stimulation of pupillary dilator Sympathetic (adrenergic) effect Parasympathetic (cholinergic) effect Figure 15.9 15-51 Pupil dilated Pupil constricted Control Without Dual Innervation • Some effectors receive only sympathetic fibers – Adrenal medulla, arrector pili muscles, sweat glands, and many blood vessels • Examples: regulation of blood pressure and routes of blood flow 15-52 Control Without Dual Innervation • Sympathetic vasomotor tone—a baseline firing frequency of sympathetics – – – – Keeps vessels in state of partial constriction Increase in firing frequency—vasoconstriction Decrease in firing frequency—vasodilation Can shift blood flow from one organ to another as needed • Sympathetic division acting alone can exert opposite effects on the target organ through control of blood vessels – During stress • Blood vessels to muscles and heart dilate • Blood vessels to skin constrict 15-53 Control Without Dual Innervation Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. • Sympathetic division prioritizes blood vessels to skeletal muscles and heart in times of emergency Artery 1 Sympathetic nerve fiber 1 Strong sympathetic tone 2 2 Smooth muscle contraction 3 Vasomotor tone 3 Vasoconstriction (a) Vasoconstriction • Blood vessels to skin vasoconstrict to minimize bleeding if injury occurs during stress or exercise 1 1 Weaker sympathetic tone 2 3 2 Smooth muscle relaxation 3 Vasodilation (b) Vasodilation Figure 15.10 15-54 Central Control of Autonomic Function • Expected Learning Outcome – Describe how the autonomic nervous system is influenced by the central nervous system. 15-55 Central Control of Autonomic Function • ANS regulated by several levels of CNS – Cerebral cortex has an influence: anger, fear, anxiety • Powerful emotions influence the ANS because of the connections between our limbic system and the hypothalamus – Hypothalamus: major visceral motor control center • Nuclei for primitive functions—hunger, thirst, sex 15-56 Central Control of Autonomic Function • ANS regulated by several levels of CNS (cont.) – Midbrain, pons, and medulla oblongata contain: • Nuclei for cardiac and vasomotor control, salivation, swallowing, sweating, bladder control, and pupillary changes – Spinal cord reflexes • Defecation and micturition reflexes are integrated in spinal cord • We control these functions because of our control over skeletal muscle sphincters; if the spinal cord is damaged, the smooth muscle of bowel and bladder is controlled by autonomic reflexes built into the spinal cord 15-57 Drugs and the Nervous System • Neuropharmacology—study of effects of drugs on the nervous system • Sympathomimetics enhance sympathetic activity – Stimulate receptors or increase norepinephrine release • Cold medicines that dilate the bronchioles or constrict nasal blood vessels • Sympatholytics suppress sympathetic activity – Block receptors or inhibit norepinephrine release • Beta blockers reduce high BP interfering with effects of epinephrine/norepinephrine on heart and blood vessels 15-58 Drugs and the Nervous System • Parasympathomimetics enhance activity while parasympatholytics suppress activity • Many drugs also act on neurotransmitters in CNS – Prozac blocks reuptake of serotonin to prolong its mood-elevating effect • Caffeine competes with adenosine (the presence of which causes sleepiness) by binding to its receptors 15-59 Drugs and the Nervous System Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. NH2 N N O H3C N N N CH3 N OH O O N N CH3 OH OH Adenosine Figure 15.11 Caffeine 15-60